IVF Round One
So here we are... IVF. I never thought I would end up here.
When Jonny and I were first trying for a baby we tried for two months (our honeymoon and the month after). Worried that something was wrong (remember I am a type A planner and worrier) I started doing ovulation tracking with Genea. With their assistance we realized that I was ovulating on day eight!! For those who don't know this is very early, most women ovulate on day 14. So for those first two months we had been trying a week late. With our new found knowledge we got pregnant the very next month. We lost our baby at six weeks, we called her/him Hope. We were devastated but together we decided to continued trying for the family we wanted.
After Hope, I had one period before we got pregnant with Mackenzie. I knew I was lucky and I was thankful. Having had friends who had struggled including one of my best friends I never took our luck for granted. I was so happy that I didn’t have fertility issue. I never thought I would need IVF.
At the same appointment that we learnt about Mackenzie’s diagnosis we were also dealt the blow of learning that for any future kids we would need IVF to make sure they were unaffected with SMA. In comparison to loosing Kenzie this information was nothing. Although I was shocked, upset and angry at the time I remember actually being thankful that I wasn’t being told that not only would we lose Mackenzie, but also that we might never have any more children. I was thankful IVF was an option. How can life put you in a situation where you can be happy about something (that normally would be devastating news) because you have been told something a billion times worse??
Forward to August 2017 and there we were sitting with Mackenzie in Dr Alison Gee’s office. She is a fertility specialist for Genea, and is the best of the best. Genea have the highest levels of success in Australia so we knew we were in the best hands. We wanted to start the process as soon as we could because we hoped that Mackenzie would be there when her sibling was born. I remember that Mackenzie slept the whole time and was the perfect baby during the appointment - as always. It was such a weird appointment sitting there with our baby knowing what will happen but planning your next. Weird would describe much of our life from now on.
Dr Gee told that they could develop a genetic test specifically for us. They would use our blood, Mackenzie’s blood, some markers sent from the US and some amazing science, which I don’t completely understand, to create a test. The test would take three months to develop but once completed it would be used to test any embryos we created through IVF. This is called Preimplantation Genetic Diagnosis (PGD). It is incredible but expensive.
On 22 October 2017, we suddenly lost Mackenzie at 7 months and 11 days. She would never know her siblings. The image of our future that I had in my head vanished. My baby girl was gone. I even knew what photo I would have used to announce the new baby, that photo included Mackenzie - a photo I would never get to take.
In the depths of our grief we were contacted in early December to say the test was ready. Jonny and I looked at each other, what do we do? We felt so lost without Mackenzie. We will always be her parents, but we were lost without our child. We had no one to look after, no one to fuss over, we were alone. We also felt old like time was getting away, when Kenzie was born we had been put at a place in life and then she was taken away - we weren’t where we thought we were. I wanted to feel a baby in my arms, my baby. So we decided to start IVF now that the test was ready. Luckily, as with everything, Jonny and I were on the same page.
As part of our treatment preparation, I had my egg levels checked. This can be done two ways. The first is called an Anti Mullerian Hormone (AMH) test and is a blood test. This showed that my levels were low which worried me. The other test is an ultrasound which counts the follicles. This test showed my levels were average to high. Confusing... and, no doubt, made things harder for Dr Gee to decide how to proceed.
The first round we did was called the antagonist round. This means I had to call the nurses when I started my period. When my levels were right I started the first injection which was 300 units of Gonal F. This was designed to make as many of my follicles create eggs as possible (rather than just one). The dose was delivered with an epi-pen style needle where you dialed in your dosage.
Jonny and I did the injections together which I appreciated since Jonny hates needles. Every morning we would sit together in Kenzie’s room so we could feel her there with us. We wanted her to be a part of it. Jonny would do the antiseptic wipe and I would do the injection. The first time I heard Jonny making gagging noises as I injected myself. Very helpful and not at all off putting – thanks, babes.
The first time I injected myself I felt very odd. It goes against everything to pierce your own skin with a sharp object but after the first time I was fine. Luckily, needles don’t bother me.
A few days later, I started the second injection of 250 units Cetrotide, which is designed to stop the body from ovulating and releasing all the lovely eggies that the Gonal F had stimulated. This was a proper needle and the solution needed to be mixed and the needle primed. I prepared the injection on the first day and then, after that, my super brave unicorn husband started preparing it while I continued doing the injection.
A few days later I started having blood tests and ultrasounds to check the size of the follicles. As soon as there were as many as possible around 18mm they told me it was time to take the trigger (which is a one-time only injection). The next morning I did my last round of hormones. My parents were there and we thought it might be good luck to do it together as a family. Mum and Dad did the antiseptic wipes, Jonny prepped the needles and I did the injecting. As always we did it on Kenzie’s nursing chair in her room. We sent as many good vibes as we could.
That night at exactly 8:30pm, I took the trigger injection.
Exactly 36 hours later, we were in Genea at the day surgery to collect the eggs. After speaking to Dr Gee, the geneticist, embryologist and anaesthetist, we waited nervously to be told to go into the surgery room. Then it was time. Again, brave Jonny said he would come into the room with me. When the anaesthetist inserted a cannula, I asked to stay mostly awake so that I knew what was happening, I wanted to know how it went (ah yep control freak). Apparently I kept talking about Mackenzie, wanting to see her again and trying to hug Jonny so they knocked me out completely.
They retrieved 11 eggs. We were so happy. Jonny took me home and we rested.
The next morning they called to say only seven were the right size (mature) and of those, only three fertilized. We were shocked.
On day three, they called to say that those three embryos were all looking ok but not great.
On day five they called to tell us that two hadn’t developed past day three and only one had made it to a blastocyst stage but it wasn’t strong enough to test.
Despite having no fertility issues we still have to create really strong day five blastocysts. Basically they have to be super-embryos because they have to be strong enough to survive a biopsy and genetic test. It is actually quite a hard process. All this while feeling bloated and sore from the egg retrieval and grieving our baby.
So our first round failed. We had no embryos. We didn’t understand how the universe could be doing this to us on top of everything else. To say we were shocked and disappointed is an understatement.
We thought that, given that we had no fertility issues, getting embryos would be easy. Our main difficulty was supposed to be the PGD. In hindsight, I’d say now that, whilst being positive is a good thing, we went into this process being too sure that we would be lucky on the first go. We should have had lower expectations. People say that the first round is like a trial run and they are right. Especially in our case, given that we had no issues technically, it is a little harder because we don’t really need the hormones. We don’t need all this process to get pregnant.
We had a follow up appointment with Dr Gee. She was surprised by the outcome, as was the lab. It appeared that the hormone levels I was given made me stim too fast, making my eggs low quality. It seems as though my higher follicle count identified by the ultrasound was more accurate than the blood test, which meant using different hormones and dosages. So we were doing a whole new cycle. Dr Gee was confident we’d be ok and we trust her.
We had the last month off over Christmas. We have spent the time preparing our bodies. At Dr Gee’s direction, I took a daily pregnancy multivitamin, melatonin, vitamin D and CoQ10. I have done daily yoga as well as weekly acupuncture and massage. Also I have continued writing to ease my stress and finally I have been on to a relatively strict low carb high protein diet.
Ok, so on to round two...